Season 1 X 11 : Detox

Original Airdate: 2/15/2005
Written by: Lawrence Kaplow & Thomas L. Moran
Directed by: Nelson McCormick
Transcript by: Mari

BEGINNING

(A male and female teenage couple are making out on a bed in his room.)

Pam: (breaks away) What d'you say now?

Keith: I dunno.

Pam: You said your dad wouldn't be home for an hour.

Keith: I know but it-

Pam: Don't you love me?

Keith: Of course, you know I-

Pam: Than come on. Let's do it!

Keith: (hesitates) Alright.

Pam: (kisses Keith and breaks away again) Where are they?

Keith: Night stand.

Pam: (fumbles is night stand and pulls something out) Gentlemen. Start your engines. (holds up... car keys!)

(We see Keith and Pam zipping around dangerously in the Porsche.)

Pam: I so want this car! Wahoo! (Keith is laughing and then starts coughing- hard while Pam continues driving recklessly. Pam eventually looks up in the rear view mirror and sees that there's blood spattered on it.) Oh, my God, you're bleeding!

Keith: (looks ahead) Look out!

(The car does a 360 and slides under an on-coming tractor trailer. They stop and are both quiet- but then a bus hits them on Keith's side of the car.)

(Opening credits.)

(We see Pam in Keith's hospital room where his entire leg is in a cast. Pam is standing at the foot of the bed while Keith's father is standing beside him.)

(We're now magically transported to the pharmacy where House is standing impatiently. Uh-oh. Somebody's in trouble... House is drumming his fingers on the counter.)

House: What lie are they telling you?

Pharmacist: (puts his hand up to House and speaks into the phone) Okay, yes.

House: Come on.

Pharmacist: Alright. Thank you. (hangs up) Okay. Pharmaceuticals were delivered this morning but but shipping accidently sent the box with Vicodin to Research.

House: Hmm. That's a tough one. If only we had some way to communicate with another part of the building. (picks up the phone for the pharmacist.)

Cameron: (who has just entered) Sixteen-year-old MVA victim. He's been in-and-out of the hospital for three weeks with internal bleeding. No one can find the cause.

House: Internal bleeding after a car accident. Wow, that's shocking. (to Pharmacist) Let me talk to shipping, I speak their language.

Cameron: It's been three weeks-

House: (to Cuddy who is nearby) Your hospital doesn't have my pain medication.

Pharmacist: Shipping says it's gonna be an hour.

Cuddy: (to phone) This is Dr. Cuddy...

Cameron: The crash didn't cause the bleed.

House: Right. The bleed caused the crash. Blood got on the road, got all slippery. (to clinic area) Anyone here got drugs? (most just stare at him but one man raises his hand)

Cameron: She saw his blood, she got distracted, she crashed his dad's Porsche.

House: Dad loved that.

Cameron: He was-

House: Don't talk.

Cuddy: It's gonna be an hour.

House: Thank God you took control.

Cuddy: If you can't wait one hour to get-

Cameron: The kid's got hemolytic anemia.

Cuddy: Kid? How old? (looks at file)

House: He must have inherited it. He's gonna die. My condolences.

Cameron: Wasn't inherited. The problem's outside the red blood cells.

Cuddy: This is impossible. A sixteen-year-old does not get hemolytic anemia-

House: Give her back the file! You have bigger problems to attend to, like my meds.

Cuddy: (reading chart) Elevated indirect bilirubin, low-serum haptoglobin...

House: He's got meningitis.

Cuddy: Uh, no.

House: Artificial heart valve. (takes file)

Cameron: No.

House: (studies file) Get everyone in my office.

(Now in House's office with House and the ducklings, all ready to get down to business.)

House: Kid's gonna be dead in a matter of days if we don't figure out why his red blood cells are disintegrating. So, differencial diagnosis, people.

Foreman: It's not environmental. Dad hired a company to clean the house, maid washed all the clothes, bought hypo-allergenic sheets and pillows.

Chase: You want us to re-check?

House: No. If it's environmental, he'll get better from just staying here.

Foreman: Could be an infection.

Cameron: No fever, no white count.

Foreman: Well, he's 99.2.

Cameron: Barely above normal.

(House checks his watch. Getting a bit ansy, are we?)

Foreman: But above. His body's reacting to something.

Cameron: We could account for the lack of fever and white count if it's lupus.

Chase: Drugs'll fit just as well as lupus. Meth'll cause hemolytic anemia.

Cameron: A lot of meth.

(House is pacing the room and looks generally miserable.)

Foreman: Also doesn't exactly seem like the type.

Chase: Because his dad drives a Porsche? Rich kids do drugs just like poor kids.

Foreman: (grins) Didn't mean to offend you.

House: Okay, so, it's infection, lupus, drugs or cancer.

Cameron: Cancer?!

House: Why not? Great meeting. (goes to leaves)

Cameron: Shouldn't we narrow it down before we finish?

House: My leg gave us until 11:15. I'll talk to Wilson about lymphoma. (to Cameron) ANA for lupus, (to Chase) radioimmunoassay for drugs and (to Foreman) you... test for whatever you thought it was. (leaves) I've got a date with a pharmacist.

(Shot of Cuddy in her office. She sees House whizzing by to the pharmacy counter.)

House: Come on, come on, come on.

(Pharmacist puts a bottle down and House snatches them up, shakes a few- five maybe?- into his hand and dry-swallows them. Mmm. Vicodin-y goodness. Cuddy sees him doing this and goes out to talk to him.)

Cuddy: You know, there are other ways to manage pain.

House: Like what? Laughter? Meditation? Got a guy who can fix my third chakra. (walks away)

Cuddy: (following him) You're addicted.

House: If the pills ran my life I'd agree with you but it's my leg that's busy calendaring what I can and cannot do.

Cuddy: You're in denial.

House: Right. I never had an infarction in my leg. No dead muscle, no nerve damage. (pushes the elevator button) Doesn't even hurt. Kinda tickles actually. The chicks dig this. (holds up cane) Better than a puppy.

Cuddy: It's not just your leg. You wanna get high! You're doing what, 80 milligrams a day?

House: No, that's way too much! Moderation is the key. Unless there's pain.

Cuddy: It's double what you were taking when I hired you.

House: 'Cause you're twice as annoying.

Cuddy: I can't always be here to protect you. Patients talk. Doctors talk.

House: About how big your ass has gotten lately? Not me, I defeand it. You got back. (they step into the elevator...)

Cuddy: (...and they step out again) You can't go a week without the drugs.

House: No, I don't wanna go without the drugs. It'll hurt.

Cuddy: No, you can't. If you're just getting off pain medication, it will hurt and you won't be having a great time but you'll make it. If you're detoxing, you'll have chills, nausea, the pain will magnify five, ten times. You won't make it!

House: Well, I guess we'll never know.

Cuddy: I'll give you a week off clinic duty if you can go a week without narcotics.

House: No way! I love the clinic!

Cuddy: You love the pills. Two weeks.

House: The pills don't make me high. They make me neutral.

Cuddy: A month.

House: (considers carefully and reaches into his pocket and tosses her the bottle) You're on, mister. (Cuddy catches them and smiles and House walks into his office.)

(Cameron is sitting with Keith's Dad in the waiting area. She's got a clipboard.)

Keith's Dad: Drugs could cause this?

Cameron: Cocaine and meth are very hard on the blood system. Has he had any erratic behavior?

Keith's Dad: No but... (looks over at Pam across the room) She was in rehab in the ninth grade. She's supposedly clean now but...

Cameron: She obviously cares for him.

Keith's Dad: What she cared about was the car. Anniversary present from my wife. We drove it up north to watch the leaves change. She was dead a year later. Cancer.

Cameron: I'm sorry... Mr. Foster we're gonna test Keith for drugs.

(Keith's room.)

Keith: I don't do drugs.

Chase: It's not that we don't trust you but... (plucks a hair from Keith's hand)

Cameron: (her voice; a vial with his hair is put into a machine) His hair will tell us any drugs he's taken over the past sixty days. Kind of like... rings on a tree.

Chase: (while looking at computer moniter) Negative.

(Waiting room.)

Cameron: Have you been sick?

Keith's Dad: No, nothing.

Cameron: Have you been out of the country?

Keith's Dad: We went to China but we got all our shots before we left.

(Keith is laying on a table being scanned.)

Cameron: (voice) It could be an infection. We’re going to give him a gallium scan just to be safe. We inject a radioactive isotope into his bloodstream and we check to see if there’s inflammation anywhere in the body.

(Foreman studies moniter. Switches back to waiting room.)

Cameron: Has he ever complained of any joint pain? (Keith's Dad shakes his head) Sensitivity to light? Rashes?

Keith's Dad: No, no. Nothing.

Cameron: Any relatives ever been diagnosed with lupus?

Keith's Dad: I don't even know what that is.

Cameron: In simple terms, the body becomes allergic to itself. The immune system attacks healthy cells in the circulatory system and destroys them.

Keith's Dad: Would it be treatable?

Cameron: It can be managable. (We see Foreman doing the test for lupus.) (voice) We can test for he antibodies. Ninety-five percent of patients with lupus have positive ANA.

Foreman: Not cloudy. Negative.

(Back in waiting room. Again.)

Cameron: What about bruising? Ever complained of tenderness under his arms or groin?

Keith's Dad: I'm not sure he'd tell me if he did. I guess I really don't know what's going on in his life.

Cameron: He's a teenager... (hesitates) What type of cancer did your wife have?

Keith's Dad: (looks like he may vomit) Pancreatic.

Cameron: It's his lymph nodes we're concerned about. (Keith's Dad gives a sigh of relief.) We're going to do a biopsy to check for lymphoma.

(We get a close-up of Wilson poking Keith's armpit area.)

Wilson: 'Kay. Can you feel this?

Keith: No.

Wilson: Good. (cuts into his flesh-ew, ew, ew!)

Keith: I have cancer, don't I?

Wilson: We're just testing.

Keith: That's what they told my mom.

(We now see Wilson, Foreman and Chase in the lab. Wilson is looking into a microscope.)

Wilson: Definitely not cancer.

(House, Wilson and the ducklings are talking outside Keith's room.)

House: Nothing?

Cameron: Nothing.

Chase: Negative for drugs. ANA was negative, gallium scan was clear-

House: Yeah. I got that from the nothing. Where's his hematocrit?

Foreman: Thirteen.

Wilson: Drops any lower he's not gonna have enough red blood cells to bring oxygen to his body. He'll suffocate with his lungs working perfectly.

(House braces the doorframe.)

Foreman: You okay?

Keith: Excuse me someone? Help?

(Ducklings rush in.)

House: Polite for a dying kid. (goes to leave)

Wilson: How long has it been?

House: I'm fine.

(Close-up of Keith.)

Keith: There's something in my eye, up at the top. (gestures to his eye)

Chase: (takes out a small flashlight) Which eye?

Keith: (gestures) This one. What's happening?

Chase: It's alright. Just look down for me. (examines eye) It's clear. (We see that Keith's view of Chase is growing darker.) There's nothing in it.

Keith: It's getting worse.

Cameron: Is it fuzzy or...

Keith: No, it's dark! (panics) I can't see.

(Pretty panning view of hospital.)

(Foreman is examining Keith;s eye with a bigger instrument. We see a big red blob in his eye.)

(The ducklings go into House's office.)

Foreman: It's a retinal clot in the left eye.

Cameron: Coumadin would dissolve the clot, fix his eyesight.

Chase: You can't use blood thinners, he's got internal bleeding. Fix the eye, you'd kill everything else.

Foreman: Well, surgery's out for the same reason.

Chase: We have two hours to figure this out. Either we restore the blood flow or he loses the eye.

(Enter House.)

House: Forget the eye. Tell him to use the other one to look on the bright side. (He honestly looks like he's miserable.) The clot tells us something. It could help us figure out what he has. (Ducklings exchange glances.) Which could mean he gets to live. Differential diagnosis, people. How does internal bleeding suddenly start clotting? (sits down and has his eyes closed)

Chase: It makes no sense, they're opposing processes.

Cameron: It can happen in lupus. Increased platelet count can cause blood clots.

Wilson: (who has just entered and is at the coffee machine) ANA was negative. It's not lupus.

House: This is true. But why are you the one saying it? What are you doing here? I thought we ruled out cancer.

Wilson: I was lonely. (sits down with a newspaper)

House: Well, go see Cuddy, she needs a friend.

Wilson: That's funny, she said you might need one.

House: That's why you're here? She wants you to keep an eye on me, make sure I don't cheat. (gets up and crosses the room so he can wince privately)

Wilson: No, I wanted to make sure you didn't start firing shots from the clock tower.

House: I'm fine.

Cameron: What's going on?

Wilson: He hasn't had Vicodin in over a day.

Foreman: Your leg hurt?

House: Ever been shot?

Foreman: There's gonna be side affects- insomnia, depression, tachycardia-

House: Withdrawal symptoms. Not applicable. The only side affects I'm gonna have are some pain and thirty days of freedom... Am I the only one that's concerned about a dying kid? If it's not lupus, what else?

Chase: Most likely candidate for throwing a clot is infection or cancer.

Wilson: Checked the biopsy twice. It's not cancer.

Foreman: It's not an infection. Gallium scan didn't reveal anything.

House: Okay. What hides from the Gallium scan? (House sees a really fit, hot woman stretching in his office. The others can't seem to see her though from where they're sitting.)

Chase: Cardiac.

Cameron: Right. Clot slips off, travels through the arteries and gets backed up in the eye.

(House continues watching her, looking both confused and amused.)

House: (turns around) I'm sorry, I wasn't paying attention. What happened?

Foreman: It's an infection in his heart?

House: Great. (nods approvingly and continues watching the woman stretching) Great. Echocardiogram for the heart and IV antibiotics for the infection, stat. (Ducklings leave and Wilson joins House) Is it my birthday? I'm not lonely! My leg hurts.

Wilson: She's a real masseuse.

House: She's five hundred dollars an hour, minimum.

Wilson: She's hot so she's a hooker? What kind of pathetic logic is that?

House: The envious, jealous I-never-got-any-in-high-school kind o' logic. Hello!

Wilson: She's a legitimate masseuse. Come on. (peers over his shoulder at her) God. She's beautiful.

House: Because she's beautiful, I should do it? What kind of pathetic logic is that?

Wilson: The envious, jealous, I'm-married-and-I-can't-do-anything logic. (Masseuse comes over.) Hello.

House: Hi. Listen, I'm sure you're really good at whatever it is you do but-

Masseuse: Dame su mano.

House: Huh? (Masseuse grabs his hands.) Hey, no. Let go of my hand. Come on-

Wilson: (whispers) She doesn't speak English.

Masseuse: Sssshhhh. (massages House's hands)

House: Ow! Ow. (She adjusts her technique.) Aaahhh... Ahhhh... Oh, my God. Bueno.

Masseuse: Take off your clothes.

(House opens his eyes. The look he has on his face right here is worth a million bucks, I swear.)

(Keith's room. His lunch is sitting untouched on the tray.)

Chase: (checks Keith's chest) Not a fan of the stroganoff?

Keith: I'm not hungry.

Chase: The antibiotics can cause nausea.

Keith: So can the food... Shouldn't you be looking at my eye?

Chase: The blood clot isn't life-threatening. We're focusing on figuring out the cause of your problems.

Keith: So the... the blindness will be permanant, won't it?

(Chase nods.)

(We see House opening the door for the masseuse.)

House: Thank you.

Masseuse: Bye. (exits)

(Chase looks curiously at House.)

House: I had a massage.

Chase: Looks like you had a messeuse! Help the pain?

House: I'm fine.

Chase: I know. Kid's echo was normal, no sign of any vegetations on heart valves.

House: Never met a diagnostic study I couldn't refute.

Chase: And the antibiotics aren't doing anything.

House: So double the dosage. Seventy milligrams.

Chase: That'll box his kidneys for sure!

House: You're right. Save the kidney. The guy we transplant it into will be grateful.

Chase: Also, I have an idea for his eye.

House: Nothing we can do 'bout his eye.

Chase: He's got a clot in his retinal-

House: Put it in a memo.

Chase: If he remove some of the liquid from the eye itself the Vitreous humor, it might make some extra room around the retinal artery.

House: (pauses in thought) If the artery expands, the clot might move on its own. That's very creative. (Chase shrugs.) Why didn't you mention this before?

Chase: I didn't think of it before.

House: You should've.

(Chase walks away, obviously disgusted. House rounds a corner and leans against a cement post and the pain has presumably returned. I guess the masseuse only alleviated the pain momentarily.)

(We see a close-up on Keith's eye and a big honkin' machine is pointed at it. Keith is surrounded by doctors in scrubs. Chase inserts a needle into the white of his eye- ew!)

Keith: This isn't going to hurt.

Chase: Your eye's numb. You'll only feel pressure. (Another needle is inserted and we see a mega close-up of the clot and surrounding area. The second needle is removed and then the first. Chase dabs away tears from below Keith's eye. We see that Keith's eyesight is coming back.)

Keith: I can see. (big smile)

(Keith's room. Pam is sneaking in quietly while Keith is resting. She kisses his hand to wake him up. Awww. Keith removes the patch from his eye and smiles at her.)

Keith: I can see you.

Pam: I heard! Congratulations. (She sounds like she's been crying and her eyes are raw. She leans in to kiss him.)

Keith: Don't. I haven't brushed my teeth is two days.

Pam: (kisses him anyway) I'm so scared there not gonna find out what's wrong with you.

Keith: No biggie. I'm fine.

Pam: I feel so bad about all this. It's all my fault.

Keith: No. No, it's not.

Pam: But your father... He hates me.

Keith: He's just pissed about his car.

(Pam leans in to kiss him again- I love this part- and Keith projectile vomits down her sweater and onto the floor.

Pam: (shouts out the door) Help! Help!

(Keith's Dad and a nurse rush in. Next thing we see is Keith laying in his bed being rolled down the hall surrounded by doctors with Pam and his father on either side of him.)

House: What's wrong?

Cameron: AST is 859. We’re getting him to the ICU.

Chase: ALT and GDT are in the tank. Our antibiotics-

House: Would not have caused this.

Keith's Father: She must've given him drugs!

Pam: I wouldn't do that!

House: (shouts) It's not drugs! (they slow to a halt) His liver is shutting down.

Keith's Dad: What?! What does that mean?

House: Means he's all better, he's ready to go home.

Keith's Dad: (heads in House's direction) What?

House: What d'you think it means? You can't live without a liver- he's dying!

Keith's Dad: What is your problem?!

House: Bum leg, what's yours?

Foreman: (steps in) We don't have time for this! Let's go. (moves Keith's Dad away from House. That's probably a good idea. They continue moving Keith's bed.)

Cameron: His son's dying and you're mocking him?

House: It was a dumb question. (House's eyes look incredibly red. Perhaps someone hasn't been sleeping well? Hmm?)

Cameron: No, it wasn't.

House: ...You're right. It wasn't.

Cameron: Is proving Cuddy wrong worth all this?

(Ducklings are talking in the Diagnostics office.)

Foreman: Y'know, House shouldn't even be here.

Chase: Because he said something inappropriate? If we sent him home every time he did that, we wouldn't need this office.

Cameron: He's in pain.

Foreman: What does the man have to do to piss you off?!

Cameron: He's been without pain relief for seventy-two hours!

Foreman: Exactly! He's detoxing! Can't you see he's out of his mind?!

(I love this next line.)

House: That's what they said about Manson. (comes around the corner and into the office) Do you want to continue talking about me or should we discuss what the liver damage tells us. (Nobody says anything.) I was born in a log cabin in Illinois-

Cameron: Hemolytic anemia doesn't cause liver damage. Add the fact he's coughing blood, you've got the three indicators of organ-threatening lupus.

House: It's moving too fast. Could be Hepatitis-E.

Foreman: There's only been one case of Hep-E originating in the US since-

House: Its history. Since he's been in and out of the country four times in the last year.

Cameron: You really think he's got Hep-E?

House: No. I think lupus is way more likely.

Cameron: Alright. Then let’s start him on IV Cytoxan and plasmapheresis. (gets up)

House: No. We should rule out Hep-E.

Foreman: You just said it wasn't Hep-E.

House: I said lupus is way more likely but if we treat for lupus and it is Hep-E...

Chase: He's toast.

House: Exactly.

Cameron: But there isn't a treatment for Hep-E. Either he'll get better on his own or he'll continue to deteriorate.

House: Yeah. I went to medical school, too. Start him on Solumedrol.

Cameron: If he's got Hep-E, it's only gonna make him worse!

House: Not as much. Goldilocks, people. Won't hurt him so much that it'll kill him and it won't hurt him so little that we can't tell. It'll hurt him just right. And if it does nothing-

Chase: We'll know it's not Hep-E and can start treating for the lupus.

House: Now watch me do it while drinking a glass of water.

Foreman: What'll we tell the dad? We think your kid has lupus so we're gonna treat him for Hepatitis-E and, oh yeah, if it really is Hep-E, we're not actually giving him Hep-E medication. So, it's gonna make it worse, not better?

House: Think he'd go for that?

Cameron: So you want us to lie?

House: No. I want you to lie.

Cameron: Why me?

House: Because he trusts you.

(Ducklings walking quickly down the hall towards the elevator.)

Cameron: This is a mistake.

Foreman: This is a law suit.

Chase: Hep-E is possible. House always pulls these stunts and he's right more often than-

Foreman: He's delaying treatment because of a one-in-a-million chance that he doesn't even think is the problem.

Cameron: I don't wanna lie to him.

Foreman: Than don't.

Cameron: And get fired?

Chase: Like he's gonna fire you. He loves you.

Cameron: I've gotta do something. (gets on elevator) Kid needs treatment.

Foreman: Treat him for lupus.

Chase: That will get you fired.

Cameron: (to Foreman) Really think House is losing it?

Foreman: Tsk. Yeah. (leaves)

Chase: He's fine. He knows what he's doing. (leaves; Cameron looks jaded and pushes the button and the elevator door closes)

(We see House alone in his office. Let's just say he's looked better. His eyes are red and his breathing his heavy. He truly looks dismal, miserable and pathetic- finally, a use for that thesaurus I bought.)

(House picks up a marble pestile and lets it drop on the table. He bangs it on the desk a few times and then- WHAMMO! He slams it down HARD on his hand. He exclaims a slur of pain and starts laughing a little bit.)

(We're just outside Keith's room now.)

Cameron: We're recommending a drug called Solumedrol.

Keith's Dad: For Hepatitis? Did that show up on his blood tests?

Cameron: (hesitates) The tests are never one hundred percent accurate.

Keith's Dad: Well, then all the other tests could be wrong too and it could still be an infection or cancer.

Cameron: They don't... fit any of the most recent symptoms.

Keith's Dad: Well, what, just Hepatitis does? (Cameron opens her mouth but nothing comes out.) I know, I know, I know. Can never be sure. When... Linda was in the hospital, the doctor told us there was this aggressive experimental treatment which might extend her life by two or three years. We figured that if there was any hope at all that we could have her with us a little while longer it'd be worth it. (He has tears in his eyes now.) Three weeks later she was gone.

Cameron: (after a long pase) I don't think it's Hepatitis. I think your son has lupus.

(We now see Wilson looking at some X-rays of some very sexy hands. Oh- look at that! They're House's! Can't House read his own X-rays?)

Wilson: I think it's broken. What'd you do?

House: Accidently closed the car door on it.

Wilson: No. Door would've broken the skin. This looks like something hard and smooth smashed it.

House: I want my lawyer.

Wilson: The brain has a gating mechanism for pain. It registers the most severe injury and blocks out the others. Did it work?

House: Well, my hand hurts like hell. Yeah. I feel much better.

Wilson: Huh. (rifles through supply drawer)

House: Don't splint it. I wanna be able to bang it against the wall if I need to administer another dose. Just tape it up.

Cuddy: (who has just entered) (to House) Why did you tell Cameron to lie to Mr. Foster?

House: (to Wilson) Make it tight.

Cuddy: Answer me.

House: (to her) Nothing I say is gonna change how you feel. And nothing could come out of your reaction that could change what I plan to do so I prefer to say nothing.

Cuddy: So, that was just you saying nothing.

House: Uh-huh.

Cuddy: The guy is furious.

House: And scared.

Cuddy: So, what are you gonna do? The father's insisting on the lupus treatment.

House: Yeah. Cameron told me and I told her to tell him no.

Cuddy: Well you can't just sit back and let the kid die.

House: And neither can the father.

Cuddy: So that's your plan? You're gonna play chicken with the kid's life?

House: Well he's the dad. I should win easily.

Cuddy: (stares at him angrily- I'm actually surprised there are fireballs erupting from her eyes) Take the week off.

House: What, 'cause I lied to a patient? I take risks. Sometimes patients die. But not taking risks causes more patients to die so I guess my biggest problem is that I've been cursed with the abilty to do the math.

Cameron: (comes in) I told him that we wouldn't treat him for the lupus until-

House: What'd he say?

Cameron: He said he wanted to transfer Keith to another hospital.

Cuddy: He's not stable enough. He'd never make it through the door.

Cameron: That's what I told him.

House: And that's when he caved.

Cameron: (very annoyed-sounding) Yeah. (big sigh) He agreed to do it your way.

House: (to Cuddy) Two plus two equals four.

(Back in Keith's room with his father at the end of the bed, Chase on one side and Cameron on the other.)

Chase: If it is Hepatitis-E, we should see a marked decline in liver function tests within the hour.

Keith's Dad: Why bother explaining it to me? It's not like I have any choice in the matter.

Cameron: If there's no Hep-E, we'll start treatment for lupus immediately.

Keith: (looks down at his chest) Ouch.

Chase: Keith? What's wrong?

Keith's Dad: What's happening?

Keith: (he starts rubbing his stomach) No, get off.

Chase: Keith? It's Dr. Chase. Where does it hurt?

Keith: Jules, no! (pushes at his stomach more frantically)

Cameron: He's hallucinating. (tries to stop him from freaking out)

Keith's Dad: Is this from the medicine?

Chase: We haven't started the medicine yet. (tries to help Cameron calm Keith down)

Cameron: ...You're in the hospital, there's nothing on you.

Keith's Dad: Keith? Keith? Keith! (Keith stares at his father and he calms down suddenly.) Hey. You okay, buddy?

Keith: (looks at them wide-eyed) I think I wet the bed.

Chase: Don't worry about it. It's fine. Let's get you up.

(They begin to roll him out and under him there's a giant pool of dark red blood.)

Keith's Dad: Oh, God!

Cameron: He's had a major bleed. Bright red blood per rectum.

Keith: I didn't mean to. I'm sorry... (his eyes roll back in his head, passes out and his moniters start beeping wildly)

Chase: He's going into hypervolemic shock. Pressure's sixty, heart rate's one-forty.

Cameron: We need an angiography stat!

(Panning shot of hospital- they seem to use quite a few of those- and we see Keith's Dad sitting beside Keith in his room. Keith is asleep. We get a close-up of a vial of blood- he is obviously getting a blood transplant)

(The team are in the Diagnostics office.)

Foreman: Angiography revealed major upper and lower GI bleeding, severe hemodynamic compromise and liver failure.

Chase: He's also hallucinating, thinks he's being tortured by someone named Jules.

Cameron: Hallucinations are a symptom of psychosis which is the forth diagnostic criterion. It's official. This is lupus.

House: (in a very dreary-sounding tone) Who's Jules? (Nobody says anything) Any mention of her in the medical history?

Cameron: It doesn't matter what he's hallucinating about, it matters why! It's lupus!

House: There's no need to get snippy. This kind of lupus takes years to get to this point. It's been a week.

Cameron: Yeah. And a sixteen-year-old shouldn't have hemolytic anemia or be bleeding out of every orfice but he is. We had an opportunity to treat this. Instead we diddled around with Hepatitis and now it's too late. He needs a new liver. We screwed up!

House: You're saying I screwed up.

Cameron: ...Yes.

House: Than why don't you just say that.

Foreman: You gonna blame this on her?

House: Did you agree with my recommendation to treat for Hep-E?

Cameron: No, I didn't.

Chase: And she made herself quite clear.

House: And then she went and lied to the father. That's why you're angry.

Cameron: Yeah. I trusted you.

House: You always trust me. It's a big mistake. (Cameron looks like she might burst into tears.) Lupus is a bad diagnosis.

Chase: It's the best diagnosis we've got.

House: It doesn't make it good.

Foreman: No. It just makes it this kid's only chance to live.

House: ...Put him in the transplant list. And make sure Cuddy knows, see if she can get him anywhere close to the top. (He hobbles off to his office while Cameron and Chase leave. Foreman follows House into his office. He walks in to see House vomiting in the garbage.)

House: (looks up at him) Cafeteria. Stay away from the sushi.

Foreman: And what happened to your hand?

House: Got stuck in a drawer.

Foreman: Yeah, right. You're going through withdrawal.

House: No, I'm going through pain. Pain causes nausea.

Foreman: (big sigh) I took this job to work with you, not cover your ass. (he sets a pill bottle on the desk) Your Vicodin.

House: (he gazes at it lovingly) And your solution is to give me drugs. It's interesting.

Foreman: No. Now I'm covering my ass. Take your pills before you kill this kid. (He exits and House cracks the bottle open and pours all the pretty Vicodin onto the desk. He picks one up, with a very shakey hand... but we don't see him take it- or put it back in the bottle.)

(We're back in Keith's room- again- with Chase and Cameron and Keith's Dad.)

Cameron: Lupus is normally treated with medication but in Keith's case the disease is to advanced.

Keith's Dad: Because you lied. Because House wanted to play games with my son's life

Chase: There's no way to really tell what progression the disease may take-

Cameron: You're right. And I'm sorry.

Keith's Dad: So what d'we do?

Cameron: He needs a new liver.

(We switch to Foreman following Cuddy into her office.)

Cuddy: There are over fifteen thousand patients on the transplant list.

Foreman: But how many are about to bleed to death unless they get a new liver?

Cuddy: In Jersey I'd say, uh, twenty. Two thousand patients die each year because a donor liver can't be found. That's almost five a day.

Foreman: So we're screwed.

Cuddy: (sigh) I'll see what I can do.

(Outside of Keith's room. Again.)

Keith's Dad: Could I donate part of my liver?

Chase: Sorry, you're a different blood type.

Keith's Dad: So we just wait?

Cameron: I'm afraid so.

Keith's Dad: And hope for someone to die.

House: (drags himself into the hall) Who's Jules?

Cameron: (glances at Foreman) Dr. House, you should get back to your office-

House: Jules. There's no Jules in the history.

Chase: It was a hullucination.

House: Of what?

Keith's Dad: (who has been watching his son from the glass window) Our cat. Does this matter?

Foreman: No, I'm sorry. We'll continue the transfusions and the treatment for the anemia and liver failure while we're waiting for a donor.

Keith's Dad: How long can he wait?

Chase: Not long.

House: (hobbles closer, looking half-asleep and close to death) I don't think this is lupus.

Cameron: It's lupus. Come on, let's just go-

House: Your forth diagnostic criterian of lupus is psychosis. This is just a kid missing his cat.

Chase: He was being attacked by an animal that wasn't in the room! That's psychosis!

House: There's a difference between psychosis and hullicinations.

Foreman: So if he was imagining a fake cat it’d be lupus but since it was a real cat it’s not? Take your damn pills.

House: Psychosis requires-

Keith's Dad: There's no cat! Jules is dead.

House: You have a dead family pet and you never mention it. Nice family history.

Cameron: Family history is asking about family members, meaning people related to the patient. Let's go.

House: How did the cat die?

Keith's Dad: Can you get him out o' here?

Cameron: Dr. House, come on, let's go-

House: What happened to the cat? (House walks past Pam sitting on a bench nearby.)

Pam: Old-age. (She stands up and comes over.) She was fifteen years old.

House: When?

Pam: About a month ago.

Keith's Dad: Does this have anything to do with-

House: Where'd she sleep?

Pam: With Keith.

Cameron: This is not a cat allergy.

House: It's not lupus. Where is Jules?

(We now see Foreman and Chase digging up the grave of Jules the Cat. You know what they say- doctors by day, grave robbers by night. No, wait. That's not right...)

Foreman: Four years of college, four at med school, two years residency, another four sub-specialty training and where do I end up?

Chase: Talking instead of digging. Come on, the ground's frozen solid.

(They stab the ground with their shovels. Stab, stab, stabbity stab. They scrape the top of the wooden coffin.)

(Next we see House, still with shaking hands, performing an autopsy- or "necropsy" since Jules is a cat and not a person- on the cat corpse. Ew. At least the thing isn't too decomposed. We see Cameron peering in at him as he does this but he doesn't see her and continues.)

(We then get a shot of a cooler being brought into the hospital.)

Cuddy: Out of the way! (on her cellphone) We have the liver. Prep OR 4. (gets on elevator with the cooler)

(Back to House, still working on the dead cat. He pulls out a tiny cat organ and sets it aside. He examines a little red lump that apparently isn't supposed to be there.)

(We then see Keith being put under anaesthesia in the OR.)

Anesthesiologist: Alright, Keith. Start counting backward from ten.

Keith: Ten... Nine... Eight... (and he's out cold. The anesthesiologist gives the okay.)

Surgeon: Scalpal. (He is just about to cut when House enters.)

House: Stop the gases.

Surgeon: What the hell are you doing House?!

House: Saving a sixteen-year-old from a lifetime of immunosuppressant drugs and a very nasty scar. This kid doesn't have lupoid hepatitis. He has acute naphthalene toxicity.

Surgeon: Naphthalene. You-you-you're talking about mothballs.

House: Nope. Termites. (holds up tweezers that are holding a termite) They creative naphthalene to protect their nests, which I'm assuming is rather large and inside all four walls of his bedroom and home. (puts tweezers down on sterilized surgery tool table)

Surgeon: And your assumption is based on what?

House: The autopsy I just conducted on his pet cat.

Surgeon: (to OR nurse) Call Cuddy. And security.

House: We're not removing that kid's liver.

Surgeon: (to nurse) Now!

(House, in blunt terms, hocks a giant loogie and spits it out on the Surgeon.)

Surgeon: HAVE YOU COMPLETELY LOST YOUR MIND?!?

House: No, but I have been feeling a little sick lately. (He grabs a towel from a nearby nurse and fakes a sneeze in Keith's direction. He tosses the towel down and leaves.)

Nurse: There's no way we can do this surgery now.

Surgeon: YA THINK?!

(Hahaha. Funny, angry surgeon.)

(We get a shot of the hall.)

Foreman: You've already cost him his liver, don't kill him too.

House: Why are you so eager to cut into a healthy kid?

Chase: Healthy?! He's in the toilet!

House: He just needs some chicken soup.

Chase: I'm telling Hourani to re-scrub. We're doing this transplant. (Ooh. Sassy!)

House: No, you're not!

Chase: You said it! If Keith's symptoms had an environmental cause, they would have disappeared as soon as he here.

Cameron: They've only gotten worse.

House: If the food here wasn’t one step below Riker’s Island he would’ve gotten better. He’s lost fourteen pounds.

Foreman: Yeah, sure, this is nothing but a dietary thing.

House: Naphthalene is a gas, a fat soluable gas. Kid breathes it in, it gets stored in his fat cells. Outside the hospital his body burned protein and carbs for energy and the naphthalene stayed in fat. But once the car accident put him in the hospital- and he started losing weight- (cool CGI thingy of the evil green Naphthalene- I didn't even mean for that to rhyme- pouring out of his fat cells) his body had to get its energy somewhere else. It started to burn fat. The floodgates opened, the poison poured into his system.

Foreman: So getting away from the poison is what poisoned him?

House: Getting away from his dad's meatloaf if what's killing him.

(Starts down hall and we see Cuddy and Keith's Dad, both looking anot amused, coming his way. Uh-oh!)

Cuddy: You wanna explain to me why you stopped the surgery?

(Keith's Dad walks briskly up to House and punches him in the jaw. Ouch! House sits the wall and the team restrains Keith's Dad.)

Cuddy: Oh, my God!

Keith's Dad: I want him LOCKED UP!

Chase: (holding him back) Hey!

Foreman: (also holding him back) Take it easy.

House: (touches his lip and sees it's bleeding) Your cat did not die of old age. He died of massive internal bleeding and acute liver failure caused by Naphthalene poisoning, the exact same thing your son has.

Keith's Dad: You lie to see, you mess up my son's surgery and now you expect me to trust you?

House: Give me twenty-four hours. We'll pump your son full of calories-

Cuddy: That liver is going to somebody right now.

Keith's Dad: We're doing that surgery.

House: (gets up) If you do the surgery, you'll be kiling a mother of four.

Cuddy: (rolls her eyes) Father of three.

House: I was guessing.

Keith's Dad: Like you are now?

House: Naphthalene poisoning is the best explanation we have for what's wrong with your son. It explains the internal bleeding, the hemolytic anemia, the liver failure... It also predicts what’ll happen next. If you do the surgery, he’s gonna lay on that table for fourteen hours while his body continues to burn fat and release poison into his system. Either way, I did you a favor. He’s awake now, you’ve got a chance to say goodbye.

Cameron: ...I think you should trust Dr. House.

Keith's Dad: (after a long, pregnant pause) Give the liver to the other guy.

(Cuddy nods and goes to make the call.)

(We're now in Keith's room- at his house, that is. We see Chase removing a poster from the wall. Foreman walks up to the bare wall with a sledge hammer, knocks on the wall to check for a stud, looks at Chase for reassurance and smashes a hole in the wall. You know what they say- doctors by day, home invaders by night. Wait. That's not right... Foreman shines a flashlight into the walls and we see many, many, many little tiny termites. Gross!!)

(Back at the hospital with a dramatic camera pan of the hospital grounds. We join Cameron, Pam, Keith and Keith's Dad in the hospital room.)

Cameron: INR is down and his blood-count is climbing. (smiles at Keith's Dad who looks unsure) Means you made the right call. His liver's healing. He's gonna be just fine.

(Keith's Dad cradles Keith's head and Cameron exits. Pam takes Keith's hand.)

(We see House and Wilson in the hall. House is looking much better today!)

Wilson: You made it a week.

House: And won my prize.

Wilson: Congratulations.

House: Cuddy's a sucker. I woulda done it for two weeks off.

Wilson: Yeah, it was a piece o' cake. Learn anything?

House: Yeah. I'm an addict. (opens the door to his office and enters)

Wilson: (enters) Uh... okay.

House: I'm not stopping.

Wilson: ...There are programs. Cuddy would give you the time. You could get on a different pain management regiment-

House: I don't need to stop.

Wilson: You just said-

House: I said I was an addict, I didn't say I had a problem. I pay my bills, I make my meals, I function.

Wilson: That all you want? ...You have no relationships.

House: I don't want any relationships.

Wilson: You alienate people.

House: I've been alienating people since I was three.

Wilson: Oh, come on! (he really sounds peeved!) Drop it! You don't think you've changed in the last few years?

House: Of course I have! I've gotten older, my hair's gotten thinner, sometimes I'm bored, sometimes I'm lonely, sometimes I wonder what it all means!

Wilson: No, I was there! You are not just a regular guy whose getting older. You've changed! You're miserable and you're afraid to face yourself-

House: (bangs his cane on a radiator or something) Of course I've changed! (Eek. House is scary when he's angry. He then looks slightly apologetic.)

Wilson: ...And everything's the leg? Nothing's the pills? They haven't done a thing to you?

House: They let me do my job and they take away my pain.

(Wilson rubs his neck, obviously thinking, and leaves.)

(We then see Wilson at the nurse's station, flipping through a file, and Cuddy joins him.)

Cuddy: How'd it go?

Wilson: He admitted he's addicted to the narcotics.

Cuddy: Well, admitting you have a problem is-

Wilson: And he says it's not a problem. (Cuddy frowns.) Maybe it's not! What do I know? (Wilson picks up his suitcases and starts off.)

Cuddy: What are y'gonna do?

Wilson: Nothing. Done enough damage.

Cuddy: Better hope he never finds out that that was your idea.

Wilson: He’d never believe it. (they leave)

(We then see House sitting in his office- stones, perhaps? LOL- with "Feelin' Alright" playing. I love that song!)

THE END